CPT 43255

Upper GI Endoscopy

Current code49 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid (state program): Washington Apple Health fee-for-service. Applies only to Medicaid enrollees.

Prices for CPT 43255 by hospital
Hospital	Medicaid (state program) rates (lowest – highest)	Cash price	List price (before discounts)
Coulee Medical CenterGrand Coulee	—	$551	$612
EvergreenHealth Medical CenterKirkland	—	$2,584	$3,230
Harborview Medical CenterSeattleFile dated 2026-04-01	—	$5,680	$8,115
Island HospitalAnacortes	—	$603	$603
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	Doctor’s fee: $400 – $500	Doctor’s fee: $615 – $769
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01	—	$2,070	$4,140
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01	—	$577	$824
Providence St Joseph HospitalChewelahFile dated 2026-04-01	—	$577	$824
Seattle Children's HospitalSeattle	$114 – $1,5351 plan	$6,091	$824 – $6,091
Skagit Valley HospitalMount Vernon	—	$3,687	$4,609
Trios HealthKennewick	—	—	$35,469
University of Washington Medical CtrSeattleFile dated 2026-04-01	—	$3,410	$4,871
Virginia Mason Medical CenterSeattle	—	$2,657 – $2,790	$5,210 – $5,471

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $820 in an office; $191 in a hospital or surgery center
Doctor's fee, rest of Washington: $717 in an office; $178 in a hospital or surgery center
Hospital outpatient payment (national): $1,960 (APC 5302)
Surgery center payment (national): $894

How hospitals also write this code

Some price files write it differently. These are counted as CPT 43255:

43255P (with a letter after it, P; 2 price lines)